全腹腔镜三角吻合与辅助小切口管状吻合在腹腔镜远端胃癌根治术毕Ⅰ式吻合术的效果比较  

Comparison of the Effect of Complete Laparoscopic Triangular Anastomosis and Small Incision Anastomosis in Laparoscopic Radical Gastrectomy for Laparoscopic Distal Gastrectomy

作　　者：曾海敬[1] 吴祖光[1] 李恩[1] ZHENG Haijing;WU Zuguang;LI En(Department of Gastrointestinal Surgery, Meizhou People’s Hospital, Meizhou, Guangdong 514031, China)

机构地区：[1]梅州市人民医院,广东梅州514031

出　　处：《现代医院》2019年第4期583-586,589,共5页Modern Hospitals

基　　金：梅州市科技计划项目科研课题(2016B038)

摘　　要：目的比较全腹腔镜下三角吻合与辅助小切口管状吻合在远端胃癌根治术毕Ⅰ式吻合的效果。方法回顾性分析2014年3月—2017年3月我科收治胃窦癌59例,其中采用毕Ⅰ式吻合19例,全腹腔镜下胃十二指肠三角吻合术6例(实验组)与小切口管状吻合胃十二指肠术13例(对照组)患者的临床资料,对两组患者年龄、BMI、术前营养状况,手术时间、手术出血量、术后病理分期、并发症、术后疼痛等级、住院时间进行比较。结果所有手术均按计划顺利完成,实验组在消化道重建时间、术后第1天、第2天疼痛等级评分、术后住院天数方面与对照组比较存在差异(P <0. 05)。在手术时间、术中出血量、术后首次排气时间、术后第3天疼痛评分均无明显差异(P> 0. 05)。两组术后均无出现吻合口出血、吻合口瘘、吻合口梗阻明显恶心、呕吐症状,胃排空障碍并发症。结论全腹腔镜下三角吻合在远端胃癌根治术毕Ⅰ式中安全可行的,比辅助小切口管状吻合具有创伤小、恢复快,疼痛轻的优势。Objective To compare the effect of complete laparoscopic Delta-shaped and small incision anastomosis with tubular anastomosis in radical gastrostomy for distal gastric cancer. Methods A review of 59 cases of gastric cancer in our hospital from March 2014 to March 2017 of them, with Billroth anastomosis in 19 cases, laparoscopic gastroduodenal triangular anastomosis in 6 cases (experimental group) and small incision tubular anastomosis of stomach and duodenum in 13 cases (control group) in patients with clinical data, the nutritional status between the two groups BMI, preoperative, operative time, blood loss, postoperative pathology, complications, postoperative pain level and duration of hospitalization were compared. Results All the operations were successfully completed according to plan. The experimental group had differences in digestive tract reconstruction time, postoperative first day, second day pain grade score and postoperative hospitalization days (control group). There was no significant difference in the time of operation, the amount of blood loss, the time of first exhaust, and the pain score at third days after operation ( P >0.05). There were no anastomotic bleeding, anastomotic leakage, anastomotic obstruction, nausea and vomiting, and delayed gastric emptying in the two groups. Conclusion Total laparoscopic triangle anastomosis is safe and feasible in radical gastrectomy for distal gastric cancer. It has advantages of less trauma, quicker recovery and less pain than the small anastomosis tube anastomosis.

关 键 词：胃癌 腹腔镜 全腹腔镜 三角吻合 管状吻合 毕Ⅰ式吻合 

分 类 号：R735.2[医药卫生—肿瘤]